Medicare rebate for obesity surgery likely to increase

Margaret Rice

A DRAMATIC expansion of the Medicare rebate system for bariatric surgery is now one step closer, bringing the popular procedures within reach of all obese Australians, following a recent review by the Department of Health and Ageing.

Bariatric surgeries work by restricting the amount of food that can be consumed and/or by reducing the body's capacity to absorb food. It is offered to those considered obese.

The number of claims for these procedures, based on Medicare items that cover the operation alone, increased from 4705 in 2005 to 11,950 in 2011. Some reports suggest as many as 16,000 procedures were completed. Sources within the Department of Health say the department is likely to implement recommendations of a recent review and expand the rebate for a range of the different procedures, putting it within reach of everyone in the community, not just those on high incomes or with high levels of medical insurance.

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But a spokeswoman for the Department of Health would only confirm ''the report is currently being considered''.

''The Medical Services Advisory Committee reviewed bariatric surgery in 2012. The MSAC Review suggested that the clinical outcomes from bariatric surgery are better and more cost effective in the long-term than non-surgical interventions,'' she said.

''Medicare Benefits Schedule rebates are available for a range of obesity surgery procedures including lap-band surgery. To qualify for a Medicare rebate you must be classified as morbidly obese and elect to have the procedure performed as a private patient. The amount of the Medicare rebate varies depending on the type of operation and only a person's doctor would be able to identify which service is appropriate for them,'' she said.

The department had fielded a larger than usual volume of queries about bariatric surgery, because of a new study on its effectiveness and safety, she said.

In mid-January, the longest study of bariatric surgery patients, conducted by a Melbourne team, was reported in Annals of Surgery. It showed a significant number of patients maintained an average weight loss of 26 kilograms more than a decade after their procedure.

The study was conducted by Professor Paul O'Brien and colleagues from the Centre for Obesity Research and Education at Monash University, which receives grants from Allergan and Applied Medical.

It analysed the results in 3227 patients who had gastric banding between 1994, when the procedure was introduced, and 2011. The patients in the study were an average age of 47 and 78 per cent were women.

Of those, 714 had surgery at least 10 years ago and had maintained an average weight loss of 26 kilograms. Similar results were found for the 54 patients who underwent treatment more than 15 years ago.

The federal president of the AMA, Steve Hambleton, welcomed any move to change the MBS, widening the rebate that could be accessed by patients wanting bariatric surgery.

The cost, particularly compared with other MBS items, had not kept pace with the Consumer Price Index, he said.

''The evidence in favour of it is now overwhelming, the benefits have been well and truly established,'' Dr Hambleton said.

In addition, its impact in reducing symptoms of type 2 diabetes showed the value of the surgery, he said.

However, he warned bariatric surgery shouldn't be seen as a panacea that could be applied after a lifetime of over-eating. ''It is only part of the solution. Lifestyle changes and diet still need to be applied in order for it to be successful,'' he said.